Who We Are and What We Do

Cancer is a deadly disease that affects individuals, families, and communities. Today more and more women are being diagnosed with reproductive organ-related cancers at a younger age. Unfortunately for many of these women, this means that they not only have to come to terms with battling a deadly disease, but their reproductive ability may be at risk or destroyed due to radiation, chemotherapy, and other cancer treatments. For these reasons, preservation of fertility is becoming an immensely important area in cancer research.

It's also why we founded the Cancer and Fertility Society. Since its inception in 2002, the Society's mission has been to improve the lives of patients with cancer or other conditions that inhibit their ability to conceive, by increasing their chances of fertility, improving treatment methods, and educating cancer experts.

The renowned surgeons associated with the Cancer and Fertility Society have been working on cancer and fertility issues for over a decade. During the past few years, unique cancer surgeries have been performed here, many of which set important precedents in the area of cancer treatment.

The Cancer and Fertility Society is dedicated to pioneering reproductive techniques that give cancer patients more effective and less invasive fertility options. These include mini-in-vitro fertilization, which utilizes a less aggressive form of reproductive hormone treatment, and egg preservation, which allows cancer patients to preserve their eggs before receiving chemotherapy. Most important, during the past few years the Cancer and Fertility Society has made crucial breakthroughs in organ transplantation in humans.

In 2005, the Society's surgical team performed this country's first abdominal radical trachelectomy on a woman in the early stage of pregnancy. This groundbreaking new procedure utilized novel surgical techniques that the Society’s team was instrumental in developing over the past ten years. It not only cured the patient's cancer, but miraculously saved her pregnancy and preserved her fertility.

Who we are has a great deal to do with where we are from. The most productive collaborations often involve people from diverse backgrounds. The Society has benefited from the participation of patients, members and doctors from all over the world. Interest and support has come from Europe especially Hungary and the United Kingdom, Asia especially Japan, and the United States.

Achievements:

The CFS physician/scientists have systematically tackled problems that affect cancer patients and many other women. With the traditional medical approach, cancer cures sometimes come at the expense of quality of life, and especially at the expense of fertility. CFS research efforts have introduced gentler alternatives that protect fertility through each stage of disease management including diagnosis, prevention, treatment and if necessary, even “salvage” therapies.

Diagnosing cancer often requires an invasive biopsy. In the case of female genital cancer, the biopsy is often a dilation and curettage or “D&C”. Although the D&C may be the gold standard for diagnosis, it can actually rob a woman of her fertility by damaging the womb. CFS introduced a very delicate replacement biopsy procedure that has virtually eliminated the need for a D&C in some practices. The “endometrial brush biopsy” has been used in thousands of patients without complications or loss of fertility.

Preventing cancer can be achieved only by first accurately diagnosing it through the “brush”. Once a pre-cancerous condition is diagnosed, non-toxic preventative treatments can be used. For instance, the standard treatment of an abnormal Pap smear is to destroy part of the cervix where the Pap smear comes from. Millions of women each year have abnormal Pap smears. Current therapy is effective but exposes women to impaired fertility and increases the chance of preterm delivery dramatically. CFS collaboration has introduced the first randomized clinical trial of a vegetable derivative, made entirely from cabbage! When taken as a pill for 12 weeks, up to 90% of women will improve! No destructive treatment was needed in nearly all of the women in this landmark study.

Treatment for actual cancers will always be needed despite these breakthroughs in diagnosis and prevention. CFS has developed new medical treatments and surgical techniques for treating patients with cervical cancer, designed to preserve fertility without compromising cancer treatment. The organization has also worked to develop new medical therapies to avoid surgical impairment of fertility, together with new treatments for pregnant women with cancer.

CFS has greatly improved the radical trachelectomy. The radical trachelectomy is the most widely used technique to preserve fertility while treating cervical cancer. A few centers, including our group of surgeons, started doing this surgery in the early 1990’s. However, for many women this challenging operation was not available in their country. Something had to be done to simplify the trachelectomy so that women everywhere would have access. Through years of research and testing, the CFS surgeons were able to ‘re-invent’ the trachelectomy technique so that specialists all around the world could learn and use it. Now the same cures and fertility preservation techniques that are available to women in North America, are available to women in developing countries

Salvage is the last hope for many cancer patients. In 2005, the Society's surgical team performed the first abdominal radical trachelectomy in the United States, on an eleven week pregnant patient. Her pregnancy was still viable after successfully removing the tumor and her future fertility was preserved. In the unfortunate patient who must have a hysterectomy or for women who are born without a uterus, perhaps the ultimate salvage option is reproductive organ transplantation.

The ultimate goal of uterine transplantation is to salvage a woman’s fertility when all else has failed. Adoption is encouraged, however, for some women adoption is not an acceptable choice. CFS prior research efforts have now led us to the point of interviewing patients to receive a human uterine transplantation. Working through traditional organ donor networks, the surgeons of CFS have conducted preliminary surgeries in preparation for a uterine transplantation. Candidates for the transplant are working their way through the extensive preoperative process right now.

Through CFS medical interventions, cancer can be better diagnosed, prevented, treated and patients salvaged. However, even when these advances work perfectly, some patients will have unrelated secondary infertility. To address the impaired fertility of cancer patients, CFS has revolutionized assisted reproductive techniques such as IVF (in-vitro fertilization). Until the work of the CFS, infertility treatments were the privilege of a small group of fortunate patients. Through the development of new medical treatments that are less invasive, safer and less expensive, more cancer survivors can have access to the latest IVF techniques.

Projects in Development:

New techniques in surgery to treat pregnant patients with cervical cancer with successful preservation of pregnancy
Ovarian transplant as a technique for restoration of fertility
Uterine transplantation for restoration of fertility
New Cancer and Fertility Center at New York Downtown Hospital